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Oral bacteria could play a crucial role in pancreatic cancer detection

Members of the research group (from left): Rogier Aäron Gaiser (postdoctoral), Haleh Davanian (postdoctoral), Katie Healy (PhD student), Dr Margaret Sällberg Chen (research group leader), Liyan Lu (PhD student) and Hassan Alkharaan (PhD student). (Photograph: Angelika Silbereisen/Karolinska Institutet)

Tue. 26. March 2019

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SOLNA, Sweden: In a recent study, researchers at Karolinska Institutet have found a link between the presence of oral bacteria in cystic pancreatic tumours and the severity of the tumour. The findings could help improve the diagnosis and treatment of pancreatic cancer and avoid unnecessary surgery.

The researchers examined the presence of bacterial DNA in fluid taken from 105 patients’ pancreatic cysts and compared the type and severity of the tumours. To identify the bacteria, the researchers sequenced 35 DNA samples that contained high amounts of bacterial DNA. They found that the fluid from cysts with high-grade dysplasia and cancer contained much more bacterial DNA than that compared with benign cysts.

“We find most bacteria at the stage where the cysts are starting to show signs of cancer,” said co-author Dr Margaret Sällberg Chen, an associate professor and senior lecturer at the institute. “What we hope is that this can be used as a biomarker for the early identification of the cancerous cysts that need to be surgically removed to cure cancer; this will in turn also reduce the amount of unnecessary surgery of benignant tumours. But first, studies will be needed to corroborate our findings.”

According to Sällberg Chen, the findings could help re-evaluate the role of bacteria in the development of pancreatic cysts. If further studies prove that bacteria affect the pathological process, it could lead to new therapeutic strategies using antibacterial agents.

The researchers also looked at factors that could affect the amount of bacterial DNA found in the tumouric fluid and reported higher DNA bacterial presence in patients who had undergone invasive pancreatic endoscopy. “The results were not completely unequivocal, so the endoscopy can’t be the whole answer to why the bacteria is there,” said Sällberg Chen. “But maybe we can reduce the risk of transferring oral bacteria to the pancreas by rinsing the mouth with an antibacterial agent and ensuring good oral hygiene prior to examination. That would be an interesting clinical study.”

The study, titled “Enrichment of oral microbiota in early cystic precursors to invasive pancreatic cancer”, was published online on 14 March 2019 in Gut ahead of inclusion in an issue.

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